WASH and CLEAN on the labour ward: a
situational analysis in India & Bangladesh
1. Collaborating institutions: Indian Institute of Public Health, Gujarat (IIPHG), BRAC
Bangladesh, Immpact – University of Aberdeen, UK, The Soapbox Collaborative, UK
2. Key Contact:
Suzanne Cross, Senior Programmes Officer, The Soapbox Collaborative,
[email protected]
Research overview:
This study aims to develop and pilot a suite of tools for capturing objectively levels of cleanliness
and the determinants, processes and outcomes of cleaning on the labour ward.
This collaborative piece of work is being undertaken in partnership between the Indian Institute of
Public Health, BRAC in Bangladesh, Immpact, University of Aberdeen and the Soapbox Collaborative,
UK. The work involves the development and use of a number of novel research methods for
capturing evidence on cleanliness and the relationship to water, sanitation and hygiene (WASH)
conditions and infection prevention and control (IPC) on health facility maternity units. The methods
include the use of participatory photography and photo-elicitation, simple microbiology methods
and the involvement of ward cleaners in data collection and the capture of visual evidence.
The tools are being applied to maternity units in health facilities in Gujarat State, India, and in
Mymensingh District and Dhaka City, Bangladesh to allow for the evaluation of findings crossculturally. The Formative Phase of the project reached completion earlier this year with the piloting
of the tools in two health facilities in India and two in Bangladesh. Following synthesis of the
Formative Phase results and refining of the tools the Situation Analysis Phase is now underway in
seven facilities in India and eight facilities in Bangladesh. Preliminary results of data collection point
to the value of the work being conducted around an often neglected yet essential issue – the state
of WASH and IPC on the labour ward.
Objectives:
1. To develop and pilot the above mentioned suite of tools.
2. To apply the suite of tools to a small stratified sample of maternity units in Gujarat State,
India, and in Mymensingh District and Dhaka City, Bangladesh.
3. To synthesize, translate and communicate the findings, including identification of potential
candidate improvement interventions for subsequent work.
Methodology:
The study adopts a mixed-methods approach, combining qualitative and quantitative techniques
including interviews with management, healthcare providers, cleaners and women who have
recently delivered in focus facilities; a facility questionnaire and a walkthrough checklist. The
methods integrate novel elements in terms of the use of microbiology and photo-elicitation.